Project Summary This project will investigate the short- and long-term effects on health care utilization and health outcomes of elderly diabetics affected by Hurricane Katrina. Over 1.5 million individuals were evacuated from the Gulf Coast due to Katrina and over 600,000 Medicare beneficiaries in Louisiana alone were affected by the storm. Seniors with diabetes were especially vulnerable to Katrina?s effects. Those affected were often unable to obtain medications, were forced to rely on replacement medications that didn?t necessarily match their needs, had to forgo necessary medical care, and experienced a lack of calories and abrupt diet changes. The analysis will employ individual-level data that identify Medicare beneficiaries with diabetes prior to Katrina in the affected areas and, for comparison purposes, in unaffected areas. The data cover the period 2002-2012, include demographic characteristics, and contain geographic information that will allow for the identification of seniors who were displaced from the affected areas. The data further specify by date the treatment received in outpatient and inpatient settings as well as prescription information Pre-post analyses will be performed across racial/ethnic groups within affected areas. Further analyses will compare individuals in affected versus unaffected areas utilizing a difference-in-differences econometric approach. The utilization analysis will examine whether there were interruptions in treatment by comparing the data in the period prior to Katrina to the period after landfall. The outcome analysis will investigate comorbidity incidence rates and mortality rates. All of the analysis will explore differences by gender and race. We expect to find that Hurricane Katrina had a significant, extended, and negative effect on seniors with diabetes. Many of these individuals had to forgo their typical treatment regimen and suffered from dramatic departures from their prescribed diet. It is further likely that these disruptions lead to increased hospitalization rates due to complications from lack of care. Finally, racial and ethnic disparities are likely present based on differences in socioeconomic status and resources available to devote to health care and well-being. Our study may provide useful information to medical professionals and policymakers. By identifying the magnitude of treatment disruptions and the associated negative health outcomes, we may assist in targeting the best response to treating senior diabetics in future disasters.